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Related Experiment Videos

Relationship between alternate-day corticosteroid therapy and behavioral abnormalities

S S Sharfstein, D S Sack, A S Fauci

    JAMA
    |December 10, 1982
    PubMed
    Summary

    Alternate-day prednisone use in patients with immune-mediated diseases can cause significant behavioral changes. These mood swings, resembling rapid cycling, depend on the drug administration day and are dose-related.

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    Area of Science:

    • Psychoneuroimmunology
    • Clinical Pharmacology

    Background:

    • Long-term alternate-day corticosteroid therapy is used for various inflammatory and immunological conditions.
    • Understanding the neuropsychiatric side effects of corticosteroids is crucial for patient management.

    Observation:

    • Three patients on alternate-day prednisone regimens exhibited distinct behavioral abnormalities.
    • Behavioral symptoms varied significantly depending on whether it was a drug administration day or a non-therapy day.
    • Observed mood cycling was reminiscent of rapid cycling in bipolar disorder.

    Findings:

    • The behavioral abnormalities were directly linked to the alternate-day prednisone schedule.
    • Symptoms on treatment days were opposite to those on non-treatment days.
    • The phenomenon was dose-dependent, with reduced symptoms upon decreasing corticosteroid dosage.

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    Implications:

    • Alternate-day prednisone regimens can induce significant, predictable mood disturbances.
    • Clinicians should monitor for such behavioral changes in patients on long-term alternate-day corticosteroids.
    • Dosage adjustment may mitigate these adverse neuropsychiatric effects.